Infant Eye Muscle Problems

It's common for newborns to have unsteady eyes or to appear cross-eyed sometimes, but this should straighten out on its own within four months. If a baby's eyes continue to be misaligned after four months, he or she may have a muscular problem called strabismus, which prevents the eyes from lining up and focusing together, or tracking an object as it moves. There are two types of strabismus, eyes turning inward or outward, and both are easily treated if detected early enough.

Crossed Eyes

• Esotropia is a condition where the eyes turn inward or appear crossed. Some babies and toddlers appear to have esotropia, but they really don't. As their facial features mature, the appearance of crossing will improve and disappear. An exam by an ophthalmologist can determine whether a child has esotropia.

Walleyes

• Exotropia is a condition where the eyes turn outward. This is sometimes called walleye, and it's less common than esotropia. Children with widely set features can appear as if their eyes are drifting outward, but an ophthalmologist often will determine that the children do not have exotropia.

Photo Test

• How can you tell whether your child has strabismus? Examine photos of your child in which the camera flash was used. In healthy eyes, the flash will reflect in the same position in both eyes, usually near the center of the pupil. In a child with strabismus, the reflection does not appear in the same position of both pupils. If you notice variation between your child's eyes, schedule an exam with an ophthalmologist.

Lazy Eye

• Untreated strabismus can lead to lazy eye, or amblyopia. This is because when a child's eyes are misaligned, he or she will use only one eye at a time to avoid seeing double. The unused or crossed eye may not develop strong vision and will start to shut down due to disuse. This can lead to blindness in the amblyopic eye.

Treatment

• Strabismus is caused by eye muscles that are improperly positioned or have an incorrect length. Strabismus can cause poor spatial perception, clumsiness and reading disabilities. Also, there can be eyelid blink reflex problems, which can result in dry eyes, irritation and infection. Doctors can treat the lazy eye by forcing the child to use it by wearing glasses or a patch over the good eye. In some cases, surgery might be needed to repair the eye muscle by re-positioning the attachments to the eyeball or adjusting the muscle length to achieve proper alignment of the eyes.

Ptosis

• Another childhood eye muscle problem is ptosis. This is a condition where the muscle that raises the upper eyelid doesn't develop properly, causing the eyelid to droop. This can be present in one or both eyes. Because the eyelid covers part of the eye, one may appear smaller than the other. If the condition is severe, surgery may be necessary to raise the eyelid.